The Longitudinal Investigation of Health and Diseases after Infertility Study 

The Longitudinal Investigation of Health and Diseases after Infertility (LIHDI) Study (R01ES033651), funded by the National Institute of Environmental Health Sciences (NIEHS), is led by Principal Investigator Dr. Lidia Mínguez-Alarcón at the Harvard Medical School and Brigham and Women’s Hospital, in collaboration with the Harvard T. H. Chan School of Public Health. The LIHDI Study aims to enroll women who were participants in the  Environment and Reproductive Health (EARTH) Study. The EARTH Study (R01ES009718) was a prospective preconception cohort led by Principal Investigator Dr. Russ Hauser at the Harvard T. H. Chan School of Public Health, in collaboration with the Massachusetts General Hospital Fertility Center. Between 2004 and 2019, the EARTH Study enrolled couples with the goal of evaluating the role of environmental, nutritional, and lifestyle factors on fertility, pregnancy, and perinatal outcomes.

The women in the LIHDI study will be enrolled at midlife to investigate past environmental chemical exposures measured during their participation in the EARTH study in relation to long-term anthropometric, cardiovascular and metabolic health outcomes, and to evaluate whether fertility mediate the associations. The LIHDI Study will focus specifically on urinary phthalate and organophosphate (OP) flame retardant metabolite concentrations (evaluated individually and also as a mixture and measured at while trying to get pregnancy, during pregnancy, and midlife) to identify the most relevant window of exposure associated with women’s health. Phthalates, often called plasticizers, are chemicals used to make plastics more durable and can be found in hundreds of products, such as vinyl flooring, lubricating oils, and personal-care products (soaps, shampoos, hair sprays). OP flame retardants are chemicals added to consumer products to reduce the flammability of many consumer and building materials. The LIHDI Study  will also explore joint and interactive effects of these chemicals and modifiable lifestyle risk factors for cardiovascular disease (BMI, diet, physical activity, smoking) on midlife anthropometric, cardiovascular, and metabolic health outcomes.


Lidia Mínguez-Alarcón, PhD, MPH, BPharm

Assistant Professor of Medicine - Harvard Medical School, Brigham and Women’s Hospital

Dr. Lidia Mínguez-Alarcón’s research focuses on identifying chemical and non-chemical stressors of human fertility, reproductive and cardiometabolic health with special focus on diet-chemical interactions and chemicals mixtures. She is also evaluating fertility measures as predictors of long-term health. Dr. Mínguez-Alarcón has been a collaborator in the EARTH Study for almost a decade and she is now the PI of the LIHDI Study. She is also the PI of another NIH grant (R01ES034700) that will evaluate paternal pesticide exposure in relation to couple s pregnancy outcomes and associations with sperm and leukocyte epigenome. Dr. Mínguez-Alarcón received her BPharm from the University of Valencia School of Pharmacy and her MPH and PhD from the University of Murcia School of Medicine. She previously completed a postdoctoral fellowship in the Department of Environmental Health at the Harvard T.H. Chan School of Public Health. She enjoys traveling and playing tennis.

Russ Hauser, MD, ScD, MPH

Frederick Lee Hisaw Professor of Reproductive Physiology, Professor of Environmental and Occupational Epidemiology - Harvard T.H. Chan School of Public Health

Professor of Obstetrics, Gynecology, and Reproductive Physiology - Harvard Medical School

Dr. Russ Hauser’s research interests are in the fields of reproductive, perinatal and pediatric epidemiology with a specific focus on the effect of environmental chemicals on male and female fertility, pregnancy outcomes and children's health. For the past twenty years, he led the NIH funded Environment and Reproductive Health (EARTH) study, conducted in collaboration with physicians and staff from the Massachusetts General Hospital to investigate the effects of chemicals classified as endocrine disruptors on male and female reproductive health endpoints. In addition, Dr. Hauser is currently co-leading the Preconception Environmental exposure And Childhood health Effect (PEACE) Study with faculty from Brown University School of Public Health. Dr. Hauser received his Bachelor of Science from Clark University, MD from the Albert Einstein College of Medicine, and MPH and ScD from the Harvard T.H. Chan School of Public Health. He enjoys traveling, yoga and hiking.

Jorge Chavarro, MD, ScM, ScD 

Associate Professor of Nutrition and Epidemiology - Harvard T.H. Chan School of Public Health 

Dr. Jorge Chavarro’s research focuses on investigating the role of nutritional factors in the pathogenesis of diseases affecting reproductive and hormone sensitive organs. He has been a collaborator in the EARTH Study for more than ten years and he is also the Principal Investigator of the Nurses’ Health Study 3 (NHS3). His work in population-based cohorts has included the identification of nutritional risk factors for infertility and conditions associated with infertility or decreased fecundity such as endometriosis, spontaneous abortion, and ectopic pregnancy, as well studies of how nutrition relates to semen quality and other markers of testicular function in healthy young men. Dr. Chavarro received his MD from the National University of Columbia and his ScD and ScM from the Harvard T.H. Chan School of Public Health.   

Kathryn Rexrode, MD 

Professor of Medicine - Harvard Medical School 

Associate Physician - Brigham and Women’s Hospital  

Dr. Kathryn Rexrode is a Professor of Medicine at Harvard Medical School and an associate physician at Brigham and Women’s Hospital in the divisions of Preventive Medicine and General Internal Medicine. Her research focuses on biochemical, genetic and lifestyle risk factors for cardiovascular disease in women and has a particular interest in the health effects of obesity and endogenous sex hormones. She is the Principal Investigator for Sex Hormones and CHD in Women (R01 NIH) and Hormonal Risk factors for CVD in Women (Doris Duke). She is also Co-Principal Investigator of the Cardiovascular Study in the Nurses’ Health Study and an Investigator with the Women’s Health Initiative. Dr. Rexrode received her MD from Case Western Reserve University and is board certified in Internal Medicine. She currently practices as a primary care physician at the Gretchen and Edward Fish Center for Women’s Health at BWH.   

Paige Williams, PhD, MS 

Senior Lecturer, Biostatistics - Harvard T.H. Chan School of Public Health  

Dr. Paige Williams’ research over the last 30 years has focused on environmental epidemiology studies and HIV-related clinical trials and observational studies, with a common focus on reproductive outcomes and child development. Her active areas of research include reproductive epidemiology in relation to environmental, nutritional, and other prenatal exposures (eg., antiretroviral treatment in women living with HIV). Her statistical interests include mediation analysis, survival outcomes, clustered data, and statistical methods for evaluation of mixtures. Dr. Williams received her Bachelor of Science in Public Health, MS in Biostatistics, and PhD in Biostatistics from the University of North Carolina at Chapel Hill.

Brent Coull, PhD

Professor of Biostatistics – Harvard T.H. Chan School of Public Health

Dr. Brent Coull’s current research interests fall into the broad areas of categorical data analysis and semiparametric regression modeling. Recent topics in the analysis of categorical data include capture-recapture mixture models, random effect models for multiple discrete binary outcomes, confidence intervals for a binomial proportion, and order-restricted methods for stratified contingency tables. In the area of semiparametric regression modeling, he has focused on the development of such models for complex data structures often encountered in public health settings, such as cross-over and longitudinal settings. He is also involved in collaborative research in environmental health, with current projects focusing on the health effects of air pollution and the interrelationship between the microbial community and pollutants in the New Bedford Harbor area. Dr. Coull received his PhD from the University of Florida in 1997. 

Briana Stephenson, PhD, MPH

Assistant Professor of Biostatistics – Harvard T.H. Chan School of Public Health

Dr. Briana Stephenson’s research has been primarily focused in using Bayesian methods to create innovative model-based clustering techniques to address data complexities found in large, heterogeneous populations. These methods were generated as a result of her collaborative research interests in maternal health, nutritional epidemiology, cardiovascular disease epidemiology, public health policy, and population health disparities. Dr. Stephenson received her Bachelor of Science from the Massachusetts Institute of Technology, MPH in Biostatistics from George Washington University, and PhD in Biostatistics from the University of North Carolina at Chapel Hill. 


Jennifer Ford, BS

Research Nurse Manager - Harvard T.H. Chan School of Public Health

Jenn began her work with the Harvard School of Public Health in 2005, initially as a member of the EARTH Study team and now as the Research Nurse Manager for the LIHDI and PEACE Studies. Over a period of 15 years, Jenn co-led the recruitment of approximately 1,000 EARTH Study participants. She has extensive experience working in reproductive and fertility medicine, having previously worked a nurse at the Massachusetts General Hospital Fertility Center before transitioning to her role in research at HSPH. She received her Bachelor of Science from the University of Massachusetts. In her free time, Jenn enjoys gardening, travel, and spending time with family and friends.

Ramace Dadd, BS

Research Assistant III - Harvard T.H. Chan School of Public Health

Ramace currently works as a senior research assistant for the LIHDI and PEACE Studies, with an expertise in lab processing and data management. He has been a fixture to the Harvard School of Public Health for over 20 years, having first joined the EARTH Study in 2002 and later supporting various additional research projects. Ramace moved to the United States from Trinidad in 1989 and subsequently obtained his bachelor’s degree in biology from Boston University. During his career at HSPH, Ramace traveled to the University of California Davis to undergo specialized training in semen analysis. In his free time, Ramace enjoys travel and learning about the historical background of the places he both visits and calls home. 

Olivia Chagnon, BS

Research Assistant II - Harvard T.H. Chan School of Public Health

Olivia began her role at the Harvard School of Public Health in June 2022 and currently works as a research assistant for the LIHDI and PEACE Studies, conducting participant recruitment, collecting and managing data, and processing samples in the lab. She graduated from Northeastern University in 2021 with a Bachelor of Science in Biology and worked as a medical assistant in dermatology prior to joining the HSPH team. Outside of work, Olivia enjoys skiing, hiking New Hampshire’s 48 4000 footers, and documenting her travels through photography. 


Maximilien Génard-Walton, MSc

Visiting PhD Student - University of Rennes, France

Maximilien Génard-Walton’s thesis research focuses on assessing the impact of chemicals, including persistent organic pollutants, metals, phenols and phthalates, on the ovarian reserve. Specifically, he uses methods to assess the combined effect of these chemicals on diminished ovarian reserve. Other topics of interest include studying the impact of climate change and microplastics on in vitro fertilization, and various female and male fertility outcomes. Maximilien Génard-Walton received his MSc in Epidemiological modeling at the University of Rennes in France. He enjoys traveling and creative writing. 

Aya Tanaka, MD, MPH

Master's Student in Epidemiology - Harvard T.H. Chan School of Public Health

Aya Tanaka is currently a Master's student in Epidemiology at the Harvard T. H. Chan School of Public Health with an interest in reproductive epidemiology. Prior to her current studies, she received her MD from Chiba University in Japan and spent 6 years working as a physician in Japan, specializing in obstetrics and gynecology. She also holds a Master of Public Health from Imperial College London. Outside of work, Aya enjoys traveling to new destinations to explore the local cuisine.

Xilin Shen, B.E.

Visiting MD Student - Zhejiang University, P.R. China

Xilin is currently a M.D. candidate of Clinical Medicine in Zhejiang University in China. Her interest is in reproductive health and assisted reproduction technology. Xilin received her Bachelor's degree in Computer Science and Engineering in Zhejiang University. She has several research experiences in data analysis and modeling with multi-omics data. She is currently a visiting student in Harvard T. H. Chan School of Public Health, to study the effects of chemical exposure to reproductive health and infertility treatment outcomes. In her leisure time, she enjoys traveling, watching musicals and Japanese animations. She is also learning tennis.